Nowadays, eight out of ten TV dramas have miscarriages, with bad to bad blood bridge “ripe” for people’s awareness of miscarriages, the endless ancient drama is creative invention of a variety of seemingly very reasonable miscarriage “common sense”, miscarriage again The female protagonist who can give birth to a litter again and again makes me admire all the way to the bottom. The screenwriter I read less you do not lie to me!
A fall will shake off a child? Pro you see too much of the court drama! The most professional doctor to correct the unreliable medical understanding of miscarriage is a serious topic, we may want to learn about miscarriage and habitual abortion together ~
There are many kinds of miscarriages
The recurrence of miscarriage can’t hurt!
What is the cause of miscarriage?
A: Miscarriage is usually referred to as spontaneous miscarriage. Spontaneous miscarriage is when the embryo stops developing before 28 weeks of gestation or is expelled from the uterus automatically. The causes of spontaneous miscarriage are complex and include: anatomical abnormalities of the uterus, genetic factors, endocrine disorders, infections and so on. In addition to spontaneous miscarriage, it also includes artificial miscarriage, recurrent miscarriage, biochemical pregnancy miscarriage, etc.
Q: I heard that white-collar workers are prone to miscarriage, is it true?
A: Miscarriage has nothing to do with occupation, but high stress and mental tension can easily lead to miscarriage. This is because if you are pregnant after work stress, emotional tension, this tension will make the body in a state of stress, so that the body’s neuroimmune and endocrine disorders, especially the level of progesterone to reduce the placenta is prone to poor development, resulting in miscarriage. Therefore, the psychological state is crucial for pregnant women.
Q: Will the activity cause miscarriage?
A: In fact, the development of embryo is like planting a tree, the sapling must develop new roots before the trunk will sprout and grow new branches, the more roots grow deeper and deeper, the more nutrients will be absorbed, the thicker and stronger the branches will grow, and the wind and rain will not push the tree down.
Placental cells are like tree roots, embryos are like tree buds, and activities are like wind and rain. As long as placental cells are rooted deep enough, all activities will not lead to abortion. If the placenta cells are not growing well, even if they lie still all day, the embryo will still miscarry due to stunting and stopping development, just like the tree will wither due to lack of nutrients even if there is no wind or rain if the roots do not grow.
There was once a certain young woman who was accidentally pregnant, and in order to abort the fetus, she deliberately performed strong exercises and kept jumping down from the bed, but in the end she failed to shake out the embryo.
Ask what is meant by habitual abortion? What is the danger of it?
A: When spontaneous miscarriage occurs twice or more, it is called recurrent miscarriage, which is what people usually call habitual miscarriage. Recurrent miscarriage will make women more and more “hurt”. This is because as the number of miscarriages increases, the condition becomes more severe and the recurrence rate of miscarriages becomes higher and higher.
For example, the recurrence rate is 25% for those who have had one miscarriage, 30% for those who have had two miscarriages, 35% for those who have had three miscarriages, and more than 50% for those who have had four or more miscarriages. Therefore, the general opinion of experts is that when 2 spontaneous miscarriages occur, you should go to the hospital to receive relevant examination.
Why do I have recurrent miscarriages?
What should I do if I have recurrent miscarriages?
Many women who have recurrent miscarriages have the question: Why do they have recurrent miscarriages even though they are healthy? What is wrong with the baby that cannot be kept? What should I do if I want to have a successful pregnancy and give birth to a baby?
Q: Why do you have recurrent miscarriages even if you are healthy?
A: In the past, only genetic factors, anatomical abnormalities of the uterus, endocrine disorders and infections were known to be the main causes of habitual miscarriage. However, in fact, most of the patients are not related to the above factors. Therefore, doctors were often helpless and patients were miserable and helpless.
With recent advances in reproductive immunology, more than half of recurrent miscarriages are found to be due to immune disorders. Immune disorders include both alloimmune disorders and autoimmune disorders, both of which predispose the embryo to death due to attack or nutritional deficiencies.
In addition to immune disorders, there may be genetic problems, endocrine problems, infection problems, etc.
Q: What tests should be done for recurrent miscarriage?
A: In case of recurrent spontaneous miscarriage, IVF failure, and fetal abortion, you should go to the hospital for a thorough examination to confirm the cause for symptomatic treatment before considering pregnancy, which can greatly increase the chances of a successful delivery.
These tests include, but are not limited to, chromosomal, blood type identification, sex hormones, thyroid function, anti-sperm antibodies, anti-ovarian antibodies, anti-endometrial antibodies, hysteroscopy, leuko, mycoplasma-chlamydia, teratogenic quadruple test, coagulation, infection, etc. The husband can also have a semen test.
The specific items to be done should follow the doctor’s instructions so that the doctor can better help treat the fetus.
Q: Should I stay in bed for miscarriage?
A: Since there are many reasons for miscarriage, the need for bed rest during miscarriage should be determined according to different situations. The following conditions should be avoided or less active: ① Pregnant women with pre-eclampsia have vaginal bleeding, especially bright red blood or pain in the lower abdomen; ② Pregnant women with late miscarriage or preterm delivery due to anatomical abnormalities of the uterus, such as cervical insufficiency and uterine malformation; ③ Pregnant women who have undergone cervical cerclage for various reasons; ④ Previa bleeding; ⑤ Although there is no vaginal bleeding, ultrasound examination reveals subchorionic or (5) Although there is no vaginal bleeding, ultrasound examination reveals a subchorionic or subfetal hematoma.
Many women with spontaneous miscarriage do not show signs of pre-eclampsia, especially those with habitual miscarriage, who do not have any discomfort until the embryo is found to have stopped developing. Therefore, in order to preserve the fetus, these women with habitual miscarriage choose to rest in bed once the pregnancy is discovered.
In fact, if there is no occurrence of the above-mentioned conditions, it is not necessary and beneficial to stay in bed for a long time during pregnancy, especially for pregnant women with habitual miscarriage due to pre-thrombotic state. Long-term bed rest is not only detrimental to the preservation of fetus, but also increases the possibility of thrombosis.
What should I do if I can’t understand the test results?
Patients with habitual miscarriage often ask these questions after the examination
Q: The test results show positive anti-sperm antibodies, is it related to miscarriage?
A: Anti-sperm antibodies may cause infertility, but they are not related to miscarriage.
Q: What does it mean when the test is negative for closed antibodies?
A: The antibody is a protective antibody that protects the embryo from being attacked by the mother’s immune cells. When the mother is close to the father’s histocompatibility antigen (HLA), the antigen is not recognized enough to produce the antibody and the embryo is easily attacked by the mother as a foreign substance, resulting in embryonic abortion or miscarriage.
However, since most patients with recurrent miscarriage are negative for closed antibodies, this indicator is of greater significance in patients with recurrent miscarriage.
Usually only one miscarriage is considered a problem with the embryo itself, as a result of natural elimination, but in the case of a negative closed antibody test and a recurrent miscarriage, treatment is required.
Q: What is the treatment for a negative pregnancy?
A: The treatment usually uses the husband’s blood, separating lymphocytes and injecting them directly to the wife for active immunotherapy, once every 2~4 weeks, each time only about 20ml of the husband’s blood needs to be taken, which can make the wife produce closed antibodies and play a role in preserving the fetus, with a success rate of over 90%.
It is important to note that if the husband has hepatitis B and the wife does not, it is best to find a healthy person who is not related to the blood donor, female donors are also available, the efficacy is the same. It is also important to adhere to the treatment after the blocking antibodies turn positive, and to maintain the treatment once every 2 months until successful delivery.
Q: I was tested positive for anti-cardiolipin antibody, is this the reason for recurrent miscarriage?
A: Anti-cardiolipin antibodies tend to cause miscarriage, and it is also the cause of some recurrent miscarriages. When antiphospholipid antibodies are formed, they tend to destroy the cells, especially the capillary epithelial cells of the embryonic circulation. When they are damaged, they will stimulate the coagulation system in the blood, causing the blood to clot too quickly and form thrombus, so that the blood circulation supplying nutrients to the embryo will be impaired and the embryo will die due to lack of blood and oxygen.
The finding of positive anti-cardiolipin antibody requires further examination to exclude rheumatic immune diseases such as systemic lupus erythematosus, rheumatoid arthritis and ankylosing spondylitis.
In addition, lymphocyte subsets should be checked, and immunoglobulin should be used for targeted treatment if there is a combination of increased toxic lymphocyte levels.
Q: For patients who had a miscarriage due to abnormal antiphospholipid antibodies, should anticoagulation therapy be continued throughout the pregnancy after conception again?
A: High blood viscosity can affect the fetus, because blood viscosity can cause poor local blood circulation in the placenta, affecting the supply of nutrients and the transport of metabolic wastes, and its effects are felt throughout the pregnancy.
Anticoagulation therapy must be adhered to. Some people are in a pre-thrombotic state, and it is very dangerous for a thrombus to form as soon as the anticoagulant medication is stopped. Treatment and monitoring must be adhered to until delivery is safe.
Low-molecular heparin is usually used for treatment because it does not pass through the placenta, so there is no need to worry about the effect of the drug on the fetus, and it is okay to use it until delivery.
Zhang Jianping: Professor and Chief Physician of the Department of Obstetrics at Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, specializing in habitual abortion, infertility, preterm labor, eugenics, prenatal diagnosis, monitoring of high-risk pregnancy, and management of pregnancy complications and complications. Patient’s gift: “They are the ones who made me a mother and saved our marriage. Here, habitual miscarriage is no longer a habit.”